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September 1986

Rapid Diagnosis of Acanthamoeba Keratitis From Corneal Scrapings Using Indirect Fluorescent Antibody Staining

Author Affiliations

From the Department of Ophthalmology, Emory University School of Medicine, Atlanta (Drs Epstein and Wilson), the Centers for Disease Control, Atlanta (Dr Visvesvara and Mr Plourde), and the School of Public Health, University of North Carolina, Chapel Hill (Mr Plourde). Dr Epstein is now with the Cornea Service, Department of Ophthalmology, Rush-Presbyterian-St Luke's Medical Center, and the University of Illinois Eye and Ear Infirmary, Chicago.

Arch Ophthalmol. 1986;104(9):1318-1321. doi:10.1001/archopht.1986.01050210072028

• Two soft contact lens wearers using a homemade saline solution developed corneal stromal inflammation and epithelial ulceration and were both treated for months with a presumptive diagnosis of herpes simplex keratitis. Subsequently, corneal scrapings revealed refractile, cystic structures consistent with the appearance of Acanthamoeba. This was rapidly confirmed by indirect fluorescent antibody studies, and Acanthamoeba castellani was later identified by growth in culture in both cases. Acanthamoeba is being reported with increasing frequency as a pathogen responsible for chronic stromal keratitis and ulceration in contact lens wearers. Since specific therapy is required to control this organism, rapid diagnosis is essential. Indirect fluorescent antibody staining of corneal scrapings provides a simple means of accomplishing this goal with a high degree of accuracy.

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